Bottom Line:
The study used data from the Maternal and Child Health component of the Urbanization, Poverty and Health Dynamics Research Programme undertaken in the Korogocho and Viwandani slums by the African Population and Health Research Center from 2006 to 2010.We found significant disparities in the coverage and timeliness of measles vaccination between the ethnic groups in Korogocho.The Luhya and minor ethnic groups in the slum were more likely than the Kikuyu to have delayed measles vaccination.

ABSTRACTThe influence of ethnicity on vaccination uptake in urban slums in Kenya is largely unknown. We examined the disparities in timeliness and coverage of measles vaccination associated with ethnicity in the Korogocho slum of Nairobi. The study used data from the Maternal and Child Health component of the Urbanization, Poverty and Health Dynamics Research Programme undertaken in the Korogocho and Viwandani slums by the African Population and Health Research Center from 2006 to 2010. Vaccination information was collected from children recruited into the study during the first year after birth, and a sub-sample of 2,317 who had been followed throughout the period and had the required information on measles vaccination was included in the analysis. Cox regression analysis was used to determine the association of ethnicity with delayed measles in the slum. We found significant disparities in the coverage and timeliness of measles vaccination between the ethnic groups in Korogocho. The Luhya and minor ethnic groups in the slum were more likely than the Kikuyu to have delayed measles vaccination. Ethnic groups with a high proportion of children with delayed measles vaccination need to be targeted to address cultural barriers to vaccination as part of efforts to improve coverage in urban slums.

Figure 1: Timing of measles vaccination uptake among the ethnic groups in Korogocho.

Mentions:
The results of the descriptive and Cox regression analysis are shown in Table 1. A total of 2,317 children (51% male and 49% female) were included in the analysis. Coverage of measles vaccine was less than 40% among males and females. The proportion of children with delayed measles vaccination ranged from 20% in females to 24% in males, although this difference was not statistically significant. The measles vaccine coverage was slightly higher among children of mothers with secondary or more education, but there was no difference in the proportion that had delayed vaccination. The wealth status of the household was not a significant determinant of delayed measles vaccination in children. However, significant differences were evident in the proportion of children with delayed vaccination among the difference ethnic groups. Children of the Kikuyu ethnic group had the highest measles coverage and the lowest level of delayed measles vaccination. Children from the Luhya and minor ethnic minorities meanwhile had the highest levels of delayed measles vaccination and lower likelihood of on-time vaccination compared to the Kikuyu ethnic group. Table 2 shows the differences among the ethnic groups in mean age and median delay at the time of measles vaccination. The results reveal a median delay of more than two weeks in the Luhya and smaller ethnic groups. The Kaplan-Meier curves show that beyond the 50th percentile, measles vaccination occurred increasingly later in these ethnic groups compared to the other ethnic groups (Fig. 1). There was no significant relationship between delayed measles vaccination and village of residence within the slum.

Figure 1: Timing of measles vaccination uptake among the ethnic groups in Korogocho.

Mentions:
The results of the descriptive and Cox regression analysis are shown in Table 1. A total of 2,317 children (51% male and 49% female) were included in the analysis. Coverage of measles vaccine was less than 40% among males and females. The proportion of children with delayed measles vaccination ranged from 20% in females to 24% in males, although this difference was not statistically significant. The measles vaccine coverage was slightly higher among children of mothers with secondary or more education, but there was no difference in the proportion that had delayed vaccination. The wealth status of the household was not a significant determinant of delayed measles vaccination in children. However, significant differences were evident in the proportion of children with delayed vaccination among the difference ethnic groups. Children of the Kikuyu ethnic group had the highest measles coverage and the lowest level of delayed measles vaccination. Children from the Luhya and minor ethnic minorities meanwhile had the highest levels of delayed measles vaccination and lower likelihood of on-time vaccination compared to the Kikuyu ethnic group. Table 2 shows the differences among the ethnic groups in mean age and median delay at the time of measles vaccination. The results reveal a median delay of more than two weeks in the Luhya and smaller ethnic groups. The Kaplan-Meier curves show that beyond the 50th percentile, measles vaccination occurred increasingly later in these ethnic groups compared to the other ethnic groups (Fig. 1). There was no significant relationship between delayed measles vaccination and village of residence within the slum.

Bottom Line:
The study used data from the Maternal and Child Health component of the Urbanization, Poverty and Health Dynamics Research Programme undertaken in the Korogocho and Viwandani slums by the African Population and Health Research Center from 2006 to 2010.We found significant disparities in the coverage and timeliness of measles vaccination between the ethnic groups in Korogocho.The Luhya and minor ethnic groups in the slum were more likely than the Kikuyu to have delayed measles vaccination.

ABSTRACTThe influence of ethnicity on vaccination uptake in urban slums in Kenya is largely unknown. We examined the disparities in timeliness and coverage of measles vaccination associated with ethnicity in the Korogocho slum of Nairobi. The study used data from the Maternal and Child Health component of the Urbanization, Poverty and Health Dynamics Research Programme undertaken in the Korogocho and Viwandani slums by the African Population and Health Research Center from 2006 to 2010. Vaccination information was collected from children recruited into the study during the first year after birth, and a sub-sample of 2,317 who had been followed throughout the period and had the required information on measles vaccination was included in the analysis. Cox regression analysis was used to determine the association of ethnicity with delayed measles in the slum. We found significant disparities in the coverage and timeliness of measles vaccination between the ethnic groups in Korogocho. The Luhya and minor ethnic groups in the slum were more likely than the Kikuyu to have delayed measles vaccination. Ethnic groups with a high proportion of children with delayed measles vaccination need to be targeted to address cultural barriers to vaccination as part of efforts to improve coverage in urban slums.